Monday, June 28, 2010

I am either a freak or a post-menopausal, overweight woman who smokes and just returned from Australia

There were moments when I feared for my life. That I wouldn't every see my kids again or live out all of my shared dreams with Christine.

So much has happened since my last post . At that point, I thought I would just live with the discomfort, see how things go, and gradually build up my training. But after this weekend, I'm grateful to be alive, see how things go, and look forward to taking a walk.

After encouraging training over the weekend, I took Monday off to go to Boston for work. On Tuesday I biked in the AM and swam at noon. Even did some good fly. On Wednesday morning, I went for an easy 6 mile run. The effort felt like a 7:15 pace, but Mr. Garmin said it was abut 8:40. I also had to walk three times. Walk. I walked not because of paid, but because I was gassed. [As a side story, near the end, I passed a guy who I see on the road many times a week. A little while ago we saw each other at an event, and realized we both know Angela. He was aware of her great achievements in triathlons. That morning, he said, "I saw you almost got Angela in that race (Pirate Tri). Nice work!" Sure, rub it in.] Wednesday noon brought a slow swim workout. All of these efforts made me feel like I was at altitude- I just couldn't get enough air in.

That afternoon, I had some sudden chest pain to the right of my sternum. Since it was to the right, I figured it wasn't a heart issue, so soldier on. I went out to dinner with my business partners. When I got home, it hurt too much to bend over to untie my shoes or even take a half breath. In addition, I have been spitting up more blood than last week. The next day I did a very easy bike on my trainer, being careful not to breathe so hard that I would cause pain in my chest. In the afternoon, Christine and I went to see our doctor, Jim. He was still thoroughly confused, but said he talked with a pulmonologist, who threw out the wild idea of a PE, or pulmonary embolism, or clot in my lungs. Jim said it didn't make sense, but was willing to try anything. He also said that in case it is, my exercise was now limited to tying my shoes until I got clearance to do more.

On Friday afternoon, we went to see the lung doc, who checked me out, performed some lung function tests, then sent me to another location for a contrast CT scan and more blood work. Last week's CT was to look for tumors. For this one, they injected a dye in my arm, at which point they had about 60 seconds to take pictures. It would allow them to see clots that wouldn't have shown up on last week's test. We did the test, and I returned to the waiting room. Minutes later, my world came crashing down.

The technician and radiologist came out and said they saw multiple clots in my lungs (I later learned 20+), and some were large. They had called an ambulance and were taking me to the Maine Medical Center ER. My brain immediately went to....clot, stroke, dead. My kids aren't with me, and I'll never see them again. This could be the end. I'll never be with Christine again. I can't be too dramatic here. Tears flowed.

There were times when I tried to stay calm. Panic wouldn't help anything. I remember the ambulance guy coming in and asking how I was doing. My response? "Other than that, how was the play, Mrs. Lincoln?"

As for the CT scan, both the lung doc and Jim were shocked by what they saw. It just doesn't fit. I have ZERO risk factors. The most common candidate for a PE? A post-menopausal, overweight woman who smokes and was just on a long flight. Yeah, that's me. I can't tell you how many times I was asked the same list of 20 questions in an attempt to find something that makes sense. Nothing fits. They drew a gallon of blood, some of which went to testing. We'll get results in a few days that might help figure this all out.

Back to the CT scan waiting room. They assured me that there was no risk of a clot going to my brain. You need a hole in your heart, between the left and right atriums for that to happen, and I had a clean echo last week. Fast forward to the ER. A very good friend, Ed, a cardiologist, was on site. It's normal for PE patients in the ER to get an echo, so the technician came in. As she was almost done, Ed arrived, and she pointed to one possible abnormality. He wasn't sure, but agreed to do a "bubble test" where they inject small bubbles in my IV. We watched on the screen as they filled one side of the heart, and sure enough, leaked through to the other side. A PFO is something that between 15 and 25% of the population has, most without every knowing it. When in utero, the lungs don't function, and there's a hole in the heart. That hole is closed by two overlapping flaps after birth, but not for me. PFOs are nothing to get worried about.....unless you have clots. Great. To make a long story short, it was another scare, makes me nervous, but intellectually is not a concern.

They moved me from the ER up to a room at 11PM. The next day, I saw Jim. He was incredibly relieved that we now know what's going on. I was, in turn, relieved to see his relief. I asked a bunch of questions and tried to remember the answers. The subject of Budapest came up. There are two primary risks with the trip. First is the flight- both the air pressure and the long inactivity. Second, a bike crash while on coumadin would not be good. Time has to go by for us to get a handle on this. At this point, I'd be thrilled to still go on the trip, put the uniform on, and just finish. It's funny to think I've had trouble coming up with a goal for this race. Now it's just to finish in one piece. As an aside, I dropped out of Urban Epic last week and Bethel last night. I'm leaving Fireman on the list in the event that we are able to go to Budapest.

On Saturday night, I had an echo on my legs. It was around 9PM, and my family had all gone home. As I lay there, she seemed to keep working on certain areas, pushing lots of buttons, etc. Given my recent track record, I was sure there was more bad news on its way. Fortunately, I tested negative for Deep Vein Thrombosis, or clots in the legs. While that's good, we're left wondering where they came from since 85% of clots come from the legs.

Most of my time in the hospital was spent in the waiting room or walking the loop around the floor. It was kind of funny how the nurses and doctors had to keep chasing me down to draw blood, take vitals, whatever. The whole time I had five leads taped to my front and a bulky wireless transmitter. This made sleeping rather difficult, in addition to the "just in case" IV sticking in my arm. At one point I was walking circles, carrying my transmitter and iPhone in the same hand. That caused some panic with my nurse as the phone caused my HR to read too high, setting off alarms.

Which reminds me of another funny story. While in the ER, I had all sorts of wires attached, and a monitor above my head that I could read. One of the numbers and graphs showed my respiratory rate. I found I could control the shape of the white line with my breath. So I slowed my breathing to 7 (per minute?), which would set off an alarm. I got a kick out of it during a pretty stressful time. Whatever works.

On Sunday morning, I learned I would go home that day. While talking with the doctor, I asked to see the CT scan from Friday. I wanted to visualize what was going on. Most of us have two lungs, and each has a pulmonary artery feeding it blood. My guess is they are about 2 cm. wide. Both of mine were/are about 85% blocked. Holy shit. That isn't far from 100% (not good). That visual will stick with me for a long time. So why was I able to function so well before, even on the day they took me to the ER? It's all about my training. To over-simplify, a "normal" person might use 30% of their lung capacity to walk down the road. If you take away 85%, they're in a deficit. I might need 10% to do the same. Take away 85%, and I still have room to operate. Training, however, also made things worse. We train ourselves to push beyond discomfort and previous limits. If we don't hurt, we aren't working hard enough. We feel something, and assume it will pass or we need to work though it. As a result, I didn't take all of this seriously enough. Now I know what it feels like, and I will not make that same mistake again.

Walking out of the hospital was tough. I felt incredibly vulnerable. The cord was being cut. What if? What if? Apparently, these feelings are very normal, and subside with time and as confidence rebuilds. I already feel better today. I can take a huge breath without pain, the first time in over two weeks. Physically, I know things will get better. Mentally, this is all pretty heavy now. It's life changing, but I realize it's too soon to know exactly how.

One final thing. Through the iPhone and Facebook, many good wishes were received. They were not only a great distraction, but also very comforting and greatly appreciated. Thank you all.

Friday, June 18, 2010

One Hell of a Week

Whoa. My last race was one to forget, and this week was one that I hope to never repeat. It was scary, reflective, and painful. And frankly, I feel odd throwing it out there for all to read about. But given that it will likely have an impact on my season and partially explains last Sunday's race, it needs to be told. I won't include every detail, but you'll get the picture.

As I mentioned in my last post, I had to quit Saturday's brick run because of the widespread and intense pain/cramping all around my torso. Sunday's sprint tri was a lousy effort, but free of pain. On Monday night, I was feeling uncomfortable in my torso, and asked Christine for a short massage. It felt good when she was doing it, but caused considerable pain and discomfort during the night. It was hard to breathe- I certainly couldn't take a deep breath- and my ribs hurt all around.

So that got me to my doctor, a great D.O., who I've been with for a long time. He poked and prodded front and back, all around my ribs, and tried to see if he could trigger the pain- without success. He drew blood, then sent me for a chest x-ray and said I'd also get an echocardiogram.

That night was the worst of my life. The only position without serious pain was my left side, but my shoulder became very uncomfortable. I took Tylenol or Advil every two hours. At about 2 AM, I tried to roll over, and got stuck. I couldn't move and could only take short, shallow breaths. It was frightening to think of all of the things that could be wrong and what they would mean. While irrational, I kept picturing Lance Armstrong's chest x-ray with all of the golf ball tumors. And triathlon, while on my mind, was WAAAAY down on the list. Sitting or standing was tolerable, so I messed around on the computer for 90 minutes. At that point, I was able to get another hour of sleep.

Wednesday night was a little better, and Thursday was much better. The further away I get from the massage or prodding, the better. Today I had a CT scan in the beautiful new Mercy facility on the Fore River. (By the way, I was in the waiting room for just 2 minutes- I was amazed by the efficiency).

So after blood tests and three diagnostic tests, what's going on? No idea. With only a couple of very minor exceptions, everything looks great. As my doc said, "The good news is we don't know what's going on. The bad news is we don't know what's going on." I have another blood test next week to see how one particular reading has changed. Other than that, his orders are to be my own judge of effort. After taking Mon-Wed off completely as planned, I swam a really slow 1,000 yards yesterday and ran a really slow 2.3 miles today. Both times it took a while to be able to breathe normally. Tomorrow I'll sit on my trainer in the garage (I'm SO excited!) and go for as long as I can tolerate it mentally.

As for Urban Epic, I'll make a judgement at the end of next week. At that point, I'll have two weeks to go and I'll know if I can train up to the level I need to. I don't want to do the race if I'm not in good form- I'd rather wait for Bethel.

In the very remote chance something is really wrong, I don't want to be one of those black swans who is incredibly healthy and keels over. And if this is just going to take some time, that's OK. The big race is in September, and my base is so strong that I can afford to go through this down time.

I look forward to getting past this week.

Sunday, June 13, 2010

Race Report: Pirate Tri- One to Forget

It bothers me to write this report, but it needs to be done. I learned something today, but it had nothing to do with the race. It has to do with training and rest.

Today was my sixth race in four weeks. Week one had two tough bike time trials. Week two had a TT and then a 4 mi road race one hour later. Week three was Mooseman, which turned into a 17 mi bike and 10k run. I've done a descent job sticking with my mid-week training, but the races did have an influence, especially this week. I just didn't have the speed or power that I'm used to. At the same time, I've been sleeping very little for several weeks, partially a result of racing (tough to turn the brain off), partially due to training (early mornings), and partially due to stress at work (wondering what the headlines would be when I wake up).

Then this past Friday, I went for a massage to help with recovery and injury prevention. My mistake was going to my #2 LMT because #1 wasn't available. He beat the crap out of me. That night, I was tossing and turning all night long, unable to get comfortable or even take a really deep breath. The next morning, I was sore getting out of bed. I went out on my scheduled 90 minute ride, which was fine- not great, it seemed a bit tough, but good enough. Then I attempted a 4.2 mile run. I wanted to hit the first 1.5 at race pace because that was my focus for today's race. After just a few strides, my entire torso was cramping up. I made it about 200 yards and had to stop. Hands on knees, deep breaths, try again, this time slower. After 50 yards, I stopped, made a 180, and walked home. I quit. I can't remember the last time I did that. I've cut workouts short, gone slower than planned, but I always did something. I could not have even run 8 min miles, so I bagged the run. Due to a forgiving family schedule, I was able to lie down for about 2 1/2 hours, including an hour of sleep and some World Cup soccer. I felt a little better at that point.

Last night, it still bothered me to take a deep breath. Getting out of bed this morning was better, but I still felt it. I got to the race early so I could get in a short bike and run and probe my body to see what was going on. It was certainly better than yesterday, but my overall energy wasn't there. As the time wore on, my torso felt better.

I swam the course for warmup and felt OK. Then we had the prerace meeting on the beach. As I was wallowing in self pity, a mother and daughter from Camp Sunshine addressed the crowd. The little girl, age 7, was diagnosed with something that sounded like cancer in the retina of her eye when she was 3 months old. She's been through so much in her young life, including having her eye removed. It was a heart wrenching story to begin with, but here's the kicker- her name was Leah, the same as my 8 year old. Life isn't fair, and that easily could be my little girl up there. We are so fortunate to have two healthy kids. That was a big wake up call for me. Who am I to complain about being tired and sore when she's been through so much more?!

The waves went off every three minutes, with the women 30 seconds behind the men. There were a bunch of people I wanted to be competitive with (beat), including Bob (my wave) and Ange (30 seconds back). I hit the first half of the swim pretty well, not seeing any of the lovely pink caps that our wave wore, which frankly, I expected. I got into the prior wave before the first turn and made it through them. At the second turn, heading back to the beach, it was far more crowded, so I took a wide berth. It added distance, but allowed me to swim without dodging nearly as many swimmers. At one point, I passed someone and basically caught their head in my armpit as I recovered my left arm, pushing them underwater. I felt terrible, but there wasn't much I could do about it. The entire return trip, the lower half of my body (which shouldn't be working), was incredibly tired and uncomfortable. I badly wanted to just take it easy getting back, but knew I couldn't. I finally finished in a long 7:53, which I'll take.

Out on the bike, the power just wasn't there. Going into the race, I wanted a more controlled effort so I could leave something for the run. My recent races have had very hard efforts, and I learned at Mooseman I need to control it better. But I couldn't even get respectable numbers. My breathing was very heavy and my HR was through the roof. My power numbers confirm the lousy results- normalized power was just 258w, compared to 274 at Polarbear and 281 at Mooseman. Bob finally caught me as we hit the access road and we had a little fun on the way back in. He ended up with a gap of 10+ seconds at the end, which I was able to make up in T2.

Out on the run, Bob put a quick 10 yard gap on me and then very slowly extended it to about 20 yards over the next 2 miles. Then at the water stop, he grabbed a cup, slowed a bit, and the gap was cut in half. I thought for a bit I'd be able to get him, but that didn't last long. Soon after, I hear someone behind be yell, "Go Ange!" Damn. There she was. Our wave started 30 seconds ahead of hers, so I knew she was going to be inside that gap. That took what little life I had left out of me, and she passed me with about 1/2 mile left to the finish.

For a small local race, the field had some great competition. Many did a 70.3 last Sunday, and to go fast for this race is impressive. I ended up 12th OA, and 2/41 in my AG. Looking at the splits, my bike should have been about 2 minutes faster, and the run at least 30 seconds better.

Those of us that are interested in training schedules know that periodization is a cornerstone. And it's a concept I've ignored. You need to rest and cut back on training every 4 weeks or so. In general, since I got back in the pool in February, I've been around 10-11 hrs/wk. Low weeks are 8 hours, and generally due to scheduling issues. There also haven't been many of those.

As a result, I'm going to take the next three days completely off. No training at all. To put that in perspective, I've taken three days off over the last four weeks. On Thursday and Friday, I'll do some light training, then go long and easy on the weekend. I get caught in the same trap that many do- we start good training in December, get to peak form for early May, and then expect to perform well through September. It just isn't realistic. My big race is September 12, so taking a few days won't hurt that- in fact, it could help. I'd like to have a really good showing at Urban Epic on July 10 to atone for today. It's a more competitive race and fun venue. So this little break will allow for a 3 week, logical, thoughtful training period.

Congratulations to all of those who are putting up some great results in local races as well as races that attract huge international talent. It's great to see Mainers doing so well. I still hope we can get a strong contingent at the USAT National Championships next year in Burlington, VT. Qualifying for the Oly race isn't too tough, and I don't think there's a standard for the sprint. Put on your schedule!

Saturday, June 5, 2010

Race Report: Mooseman Olympic Tri..errr...Duathlon

As the title suggests, we had a curveball thrown at us. Thunderstorms rolled through at about 4 in the morning, then again at 7. Had they started with a swim at 9, as opposed to the scheduled 7:30, people would have been out on the bike course too late, so they cancelled the swim and started at 9. They also shortened the bike, I think due to an unconfirmed washout situation.

I looked at this weekend as opening day for the regular season. The one sprint tri, three bike TTs and one road race were all in preparation for this. Last year I was 13th, so I hoped for a top 10. However when you take away my normally strong segment, that becomes a tall order.

It took a little while to get over the disappointment of a cancelled swim and shortened bike leg (17 vs. 27). The whole reason for making the trip was washed out, and I don't have another Oly race on the schedule. Then I heard how this duathlon was going to start- one person at a time, every THREE seconds. Are they joking? Don't they realize how congested it will be out there? I figured the only approach was to be aggressive and pass as many people as possible in the first five miles. At that point, the course hits the BIG hill and I figured people would start to get spread out. Between that strategy and my recent TT events, I hit it hard right out of the gate. I was actually surprised it wasn't more congested, but I was passing people hand over fist. Twice I had to deal with cars on the course travelling in the same direction. I passed one to the left and one to the right, nervous both times. They slowed me down, as did the few times when I had to yell at folks who were slowly "passing" other riders. I don't think it's illegal to go three abreast, as I learned at nationals last year.

I continued to work hard the whole way, with little regard for what followed. My normalized power was 281w, 18 higher than last year. Speed went from 22.3 to 23.7 this year. And my peak 5 minutes showed how aggressive I was at times- 285w vs. 315w this year. I probably wasn't as consistent as I should have been, but that was tough with all of the traffic out there. Liking to dissect results, I found there's a guy in my AG who has beaten me now three years in a row at Mooseman and the '08 and '09 nationals. Last year he beat me on the bike by 1:44. This year I beat him by :05. Good stuff. In fact, I ws tied for first in my AG. OA, I was 18th on the bike last year, and 10th this year. I consider this a huge accomplishment, and am thrilled. The hard work and racing has paid off......

.....but at a price. My run wasn't so good. I started out feeling pretty sapped, and it took forever to get to mile 1. I didn't wear a watch, so I had no idea what my splits were. At that point, I was in a groove that seemed like a fair pace, leaving a bit for the return trip. However I never got out of the groove. The speed just wasn't there. I also didn't have someone I knew, in my AG, who was trying to run me down like last year. I ended up with a disappointing 44:51, far slower than I should be.

So does that mean I biked too hard, or that I need more work on my run, or both? My hunch is it's a bit of both. If I went too hard on the bike, I'm willing to accept that. You can't find where your limits and targets are until you go past them.

As for the transition, I nailed it at 0:55. Only one person OA was under :50, and a handful under 1:00. It was funny, actually. I was out of my shoes at the dismount, and ran to my rack which was close to the bike entrance. I racked it, took my helmet off, pulled on my shoes, and then actually thought to myself, "that was too easy- what am I forgetting?" Turns out nothing. The best transitions are simple.

I ended up 30th OA with about 700 competing, and 5th of 86 in my AG. With a swim, I think I would have picked up at least one spot, and perhaps get as high as 2nd in AG. So while it isn't what I signed up for, I'm pleased with the results.

Pirate Tri (sprint) next Sunday, then I can get back to a more regular training schedule.